Ending female genital mutilation in the UK

"It is only now we realise that female genital mutilation is child abuse, many people in our home country don’t realise that”. Nasheima Sheikh reports on working with women at grassroots in Birmingham to end this illegal practice

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Female genital mutilation (FGM) is a deeply sensitive issue
and is part of the spectrum of abuse that is faced by women globally. It is emerging as an urgent public health
and social care issue in the UK due to the grave and lifelong consequences of
the practice. In 2007 it was estimated that 66,000 women in
the UK had experienced FGM with another 24,000 under 15 years of age deemed ‘at
risk’.

Though widely and mistakenly viewed as an Islamic practice,
FGM is actually practiced by many communities, including Christians, Jews, as
well as Muslims. Religious roots of the
practice are obscure and much controversy surrounds the religious scripts that
‘approve’ it. Circumcisers are most often women and community based, but there
is an increasing trend noted by the World Health Organisation of health
practitioners performing such procedures.

FGM affects an estimated 100-140 million women worldwide and
is practised primarily in Africa and the middle east. It is an extremely harmful practice that has deep roots in
culture and tradition and involves the removal of external female genitalia for
non-medical purposes; the amount of removal depends on which type is practiced
with type three
being the most radical.

As global migration increases, the practice is becoming a
problem in America
and Northern Europe, especially with a rise in populations from Africa and
the middle east. FGM has been picked up as a serious issue to be addressed by
statutory agencies, most overtly in midwifery practice and in schools. At
Birmingham and Solihull Women’s Aid (BSWA)
we identified it as a gap when we discussed issues facing the women we work
with.

The central issue with FGM is how to engage effectively with
often hard to reach communities, and particularly with women who most need
support. The subject is shrouded in
secrecy, and although it is against the law in the UK, to date, there have been
no criminal convictions.

If we are to understand what support is required from BSWA,
we need to understand who is affected in Birmingham, the prevalence of the
practice and the complex issues involved. A critical success factor early on in our work was employing a Somali
worker with a sound understanding of the practice who was able to develop good
relationships, listening and working with the community, and being sensitive to
the wider issues faced by these communities. We had learnt lessons from working on domestic violence issues, and knew
that community sensitivity was paramount.
Balancing addressing this very serious issue, while ensuring that
communities were not stigmatised, was foremost to our approach.

Our work was initially very problematic because most
community organisations were led by men, and the issues they focused on were
advice, employment and education – issues central to every newly arrived
community. Our worker, Khadija Jaamac, adopted a fresh technique of finding
African areas in Birmingham and Solihull and walking the shopping malls to find
‘natural’ places where women congregate.
She discussed issues generally with shop keepers and women before
touching upon her work. From this, women’s groups were formed, enabling
awareness raising, training and discussions on health, religion, personal
development and the law.

This approach led to nine community events on FGM at which
we showed the film Africa
Rising, directed by Paula Heredia, depicting the practice in many African
countries, and highlighting ways in which the communities were acting to discourage
it; development of four women’s groups in different geographical areas across
Birmingham and two courses for women on health, child protection, leadership
and organisation for women and youth with FORWARD, the leading FGM agency in
the UK.

We were very successful in engaging with young people. Having trained young women, one young woman,
Ayan Ali, worked with her father’s community group to organise an event on
FGM. Another young woman, Sagal Warsam,
developed her own group called NEAYA – the North East African Youth Group. They organised an event that attracted 60
young people from practicing communities in Birmingham, and Sagal reported
that, “The event gave us the opportunity to
participate and express our opinions and views about FGM and we enjoyed
listening and debating with our audience who expressed a wide range of
opinions. It was a fantastic opportunity not only to learn so many things
about it, but we also had the chance to put everything we learned into practice
through organising the event.”

Another woman who attended the
event, Rian Sharif said, “The event was not only informative, it was
interactive as well because we were able to share our insights and thoughts.
Hearing other women recount their experiences of FGM was truly
moving”.

The project also made women aware of the only FGM Clinic
locally, the African
Well Women’s Clinic. Khadija worked
alongside the specialist midwife and offered support to women who approached
the clinic. After the medical
examination from a midwife, Khadija
talked to the women individually about the law and discussed the wider
consequences of female genital mutilation. She found that many women thought they had Type 1 FGM, and were very
upset when they realized it was a more severe form they had had done. Women
were not clear of the health consequences of the procedure because they had not
realized that the lifelong heath problems they had suffered were a consequence
of FGM. Khadija also discussed the issue with male partners and found that
their views were also affected once they realised the consequences of the
operation on their wives. Some men were ignorant of FGM altogether, but after
the sessions, they often said that they did not want their daughters to have
the operation.

We
partnered with Options UK to recruit
fifteen researchers from local practicing communities, and gave them training
in participatory ethnographic evaluation research techniques. The evidence we
gathered provided real insight into understanding the experience of FGM in
Birmingham, and revealed that women were not aware of how widespread the
practice was – most believed it was a local tradition. After our sessions, women recognised that it is indeed a child
abuse issue – having previously viewing it in much the same as male
circumcision. Many younger women also believed that FGM was declining, but this
was contradicted by those who had arrived most recently - bringing with them
stronger traditions and keeping the practice alive. Although there is good
awareness that FGM is illegal in the UK,
a lot of myths persist about why it is necessary, including that it is a
religious practice. The biggest pressure to continue, as expected, is social
pressure; most women wanted to see it end after this discussion but did
not necessarily feel empowered to advocate this openly in the community, even
if they did so in their own family. Women’s views included, “we
don’t want to be stigmatised simply because we come from a country that
practices FGM”; “we want to fight against FGM”; “it is only now we realise that
FGM is child abuse, many people in our home country don’t realise that”.

The
research helped to highlight areas with the highest concentration of practicing
communities - essential in the current climate of diminishing resources because
it allows us to decide where best to concentrate efforts in addressing FGM in
Birmingham. Huge strides could be
achieved in addressing FGM if statutory bodies agreed to undertake awareness
raising of FGM, and training of professionals in GP surgeries, midwives and schools
in these areas alone.

We found
that women and young people were eager to discuss FGM once the initial barriers
had been addressed and they felt comfortable with our organisation. The project has been very successful. After attending sessions with us, 80% of
women, - from backgrounds as diverse as
Sudan, Yemen, Eritrea, Gambia, Ivory Coast and Guinea - agreed that they would
not undertake FGM on their own children, and would advocate against it within
their family. We have now trained 57 women
to be advocates in their own communities against FGM, and reached 580 women
with the messages about the reality of the practice. As Khadija says, “I am helping women in the community, who are
survivors of FGM, often for the first time, to talk about it openly and to
support them emotionally. Women have understood more about their bodies and
know how to access services – this is so important in fully understanding and
coping with the consequences of FGM”.

What is
heartening is the passion that women from the communities, old and young, feel
for the subject of FGM, and their desire to address the issue in a positive way in
their community. Once the women had more in-depth knowledge of female genital mutilations and it's grave lifelong consequences, the
vast majority of them wanted to see the practice end.

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